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New approaches to cancer immunotherapy have been developed, showing the ability to harness the immune system to treat and eliminate cancer. For many solid tumors, therapy with checkpoint inhibitors has shown promise. For hematologic malignancies, adoptive and engineered cell therapies are being widely developed, using cells such as T lymphocytes, as well as natural killer (NK) cells, dendritic cells, and potentially others. Among these adoptive cell therapies, the most active and advanced therapy involves chimeric antigen receptor (CAR)-T cells, which are T cells in which a chimeric antigen receptor is used to redirect specificity and allow T cell recognition, activation and killing of cancers, such as leukemia and lymphoma. Two autologous CAR-T products have been approved by several health authorities, starting with the U.S. Food and Drug Administration (FDA) in 2017. These products have shown powerful, inducing, long-lasting effects against B cell cancers in many cases. In distinction to the results seen in hematologic malignancies, the field of using CAR-T products against solid tumors is in its infancy. Targeting solid tumors and trafficking CAR-T cells into an immunosuppressive microenvironment are both significant challenges. The goal of this review is to summarize some of the most recent aspects of CAR-T cell design and manufacturing that have led to successes in hematological malignancies, allowing the reader to appreciate the barriers that must be overcome to extend CAR-T therapies to solid tumors successfully., Graphical abstract This review summarizes some of the most recent aspects of CAR-T cell design and manufacturing that have led to successes in hematological malignancies, allowing the reader to appreciate the barriers that must be overcome to extend CAR-T therapies to solid tumors successfully.Image 1

Undergoing a rhinoplasty can affect an individual's mental health either positively or negatively, depending upon how he or she perceives the results. Because of the impact that rhinoplasty may have on an individual's mental health and the cost of this surgery, it is important to understand the reasons that men decide to undergo rhinoplasty and the challenges they face when making the decision to have a rhinoplasty. Using a grounded theory method, we collected data by conducting interviews with 20 participants. We analyzed the data and initially obtained 684 initial codes. After we removed duplicate codes and carefully analyzed participants' interviews, a total of 497 codes remained. We developed these codes into 10 main categories and 32 subcategories. We found that the causal factors affecting the decision of Iranian men to undergo rhinoplasty included the following 5 categories: a lack of confidence; a desire to improve their appearance; a desire for attention from others; a need to keep up with the Joneses (i.e., a desire to show that one is as good as other people by getting what others have and doing what others do); and persuasion by others. Intervening factors affecting the decision of Iranian men to undergo rhinoplasty included the following 4 categories: family challenge; social atmosphere; financial problems; and unwanted consequences. Iranian men make the decision to undergo rhinoplasty by overcoming and ignoring these intervening factors. The primary variable in participants' decision to undergo rhinoplasty was the desire to improve their appearance.

Background:The precise responsible mechanism of pre-eclampsia remains controversial however, recent data suggest a main role of the abnormal activation of the adaptive immune system and Apoptosis. In this study, we have measured serum levels of Fas/Fasl as two important members of extrinsic apoptotic pathway in patient with pre-eclampsia. Methods: 207 participants including 99 pre-eclampsia patients and 108 age and sex-matched normal pregnant women were involved in the case-control study. Plasma sample from each participant was collected and stored at –20 C until batch processing. Serum levels of Fas and Fas ligand were measured by ELISA for each participant including 99 pre-eclampsia patients and 108 normal pregnant women. Following a test of statistical normality, nonparametric data were analyzed by Mann-Whitney. Results:sFas levels in case group was significantly higher than controls; 584 (397-892) pg/ml in cases opposed to 341 (213-602) pg/ml in controls (p value< 0.01). sFasL in pre-eclampsia women was a little lower than controls; 255 (173-318) pg/ml and in case group compared to 265.5 (184-381.5) pg/ml in controls. Conclusions: We have found the increased levels of sFas in patients with pre-eclampsia in compare with the healthy pregnant women. It seems that abnormality in sFAS is related with pre-eclampsia. © 2021

Objectives: Cleft lip and palate (CLP) is a congenital anomaly that affects not only the patients but also their family members and companions. Identifying the problems encountered by patients with CLP and their families can greatly help clinicians in efficient treatment planning to obviate the treatment needs and promote the quality of life of patients. This study aimed to determine the experiences of the parents of children with CLP undergoing orthodontic treatment. Methods: This study was conducted based on descriptive phenomenology using the Colaizzi’s 7-step analysis method of phenomenological data. The private orthodontic clinics of Kermanshah city were evaluated in this study. The participants included the parents of children with CLP younger than 15 years who had presented to the clinics seeking orthodontic treatment. In-depth semistructured interviews with open-ended questions were used to collect information regarding the experiences of parents in this process. The collected data were analyzed using the Colaizzi’s 7-step analysis. Results: Qualitative analysis of the interviews yielded 271 codes, 18 subthemes, 7 themes, and 3 main themes including fatigue (exhaustion, helplessness, and incompetence), self-reliance (mutual support and empathy), and the need for social support (counseling services and citizenship rights). Conclusion: In general, the results revealed that parents of children with CLP under orthodontic treatment are vulnerable due to their previous adverse experiences in the course of treatment of their children and need support in several physical, psychological, social and spiritual domains.

Background In addition to physical, mental, and social condition, ESRD and hemodialysis affect the quality of life of patients as well. Psychotherapy and non-pharmaceutical interventions are effective measures to add meaning to life, create a goal and motivation in life, and improve the quality of life in chronic patients. The effect of educational and supportive group therapy on the quality of life (QOL) of hemodialysis patients was examined. Methods The study was carried out as an interventional quasi-experimental study with the participation of 64 patients who were selected through convenience sampling and based on the patient’s hemodialysis days (Saturday, Monday, and Wednesday patients as an experimental group and Sunday, Tuesday, and Thursday patients as a control group). There were 32 patients in each group. The experimental group received eight 50 min sessions including two sessions per week. The control group received the normal interventions. The participants were assessed using a demographics form and Kidney Disease Quality of Life Short Form before, immediately after, and 1 month after the intervention. The collected data was analyzed using SPSS (v.24). Results The mean QOL scores of the experimental group before, immediately after, and 4 weeks after the intervention were 36.99, 43.3, and 44.9 respectively. Those of the control group were 36.39, 37.2, and 37.1 respectively. There was no significant difference between the two groups before the intervention (P > 0.05); however, the difference between the two groups was significant immediately after and 4 weeks after the intervention (P = 0.0001). The trend of score change in the experimental group was also significant (p p Conclusion In general, educational and supportive group therapy can expand the interpersonal relationships of hemodialysis patients and positively affect their quality of life.

Background: The Hemiscorpius lepturus (H. lepturus) is a deadly scorpion species living in the southern Iran. Objective: H. lepturus induces delayed toxicity symptoms and understanding the long term biodistribution/ biokinetic of the venom is of great interest in toxicology. Methods: A Ga-67 labeled venom was prepared using a DOTA -conjugated venom followed by radiolabeling using 67GaCl3 at 40°C for 90 min. The purification of the radiolabeled venom was performed using size exclusion-chromatography (radiochemical purity 71%). The radiolabeled venom was stable in the final solution in the presence of human serum at 37°C for 72 hours. The tissue distribution was studied in blood, heart, liver, spleen, muscle, brain, kidney, intestine and skin tissues at the intervals of 1, 4, 24, 48 and 72 hours using tissue counting and SPECT imaging. Results: The radiolabeled venom mixture obtained with an estimated molar activity of 0.52 MBq/μg. The main accumulation tissues during the first 72 hours were kidneys, blood, liver, intestines, stomach and skin, respectively. Therefore, it is likely that H. lepturus’ clinical effects and renal toxicity are primary and caused by direct effects of the H. lepturus venom. Conclusion: The results have largely shown the direct clinical effects on the studied tissues during the 72-hour period and antivenom administration can strongly alleviate the toxicity effects as early as 72 hours in the management of the patients.

The aim of this study was to explore the effectiveness of Methadone Maintenance Treatment (MMT) from the perspective of drug users and their families. For this qualitative content analysis study, 1...

Introduction Today, a new paradigm has emerged for cancer treatment introducing combination therapies. Doxil, a liposomal doxorubicin serving as a chemotherapeutic agent, is an effective immunogenic killer of cancer cells. Anti-CTLA-4 has been approved for the treatment of some cancers, including melanoma, but side effects have limited its therapeutic potential. Methods In this study, two approaches were utilized to increase treatment efficiency and decrease the side effects of anti-CTLA-4, combining it with chemotherapy and encapsulation in a PEGylated liposome. A different sequence of anti-CTLA-4 and Doxil was assessed in combination therapy using non-liposomal and liposomal anti-CTLA-4. Results Our results showed that liposomal anti-CTLA-4 reduced the size of established tumors and increased survival in comparison with non-liposomal anti-CTLA-4 in a well-established B16 mouse melanoma model. In combination therapy with Doxil, only the administration of anti-CTLA-4 before Doxil showed synergism in both non-liposomal and liposomal form and increased the CD8+/regulatory T cell ratio. Discussion In summary, our results demonstrate the potential of utilizing a nanocarrier system for the delivery of checkpoint blockers, such as anti-CTLA-4 which further showed potential in a combination therapy, especially when administered before chemotherapy.

Uterine artery embolization (UAE) has been introduced for uterine fibroid treatment for two decades. Most of the patients are in reproductive age and many want future pregnancy. In this study, we will assess fertility, pregnancy and its outcomes in patients who have undergone UAE. In this systematic review, a systematic search was performed on important databases including PubMed and Medline, Web of Knowledge, Google Scholar, EMBASE and Scopus. Studies reported enough data about pregnancy after UAE were considered to be enrolled in the review. We assessed obstetric indices (pregnancy and delivery rates, pregnancy losses, complications and fetal outcomes). Study evaluation was done based on STROBE checklist by two reviewers. Totally, 24 original papers were included. Data were analyzed by Stata and MedCalc softwares. Among women wishing fertility, totally 40.5% experienced at least one pregnancy after UAE (95% confidence interval [CI]: 33.3%-48.2%). Pooled estimate of pregnancy loss rate was 33.5% (95% CI: 26.3-41%). Most pregnancy losses were due to spontaneous abortion (81.3% of all losses (95% CI = 76%-86.1%)). Rate of obstetrical complications was 25.4% (95% CI = 13-40.2%) among all finished pregnancies. Pooled estimate of preterm labor was 12.8% (95% CI = 8.7%-17.5%), and pooled estimate of low birth weight (LBW) was 10% (95% CI = 6.2-14.6%). Considering the findings of the study, a safe pregnancy after UAE is obviously possible resulting to a healthy and normal baby delivery. In addition, pooled obstetrical complication rates, pregnancy losses, preterm labor and LBW seem to be mostly similar to the general population. Registration: The study was registered in International Prospective Register of Systematic Reviews (PROSPERO) on Nov 3, 2017, and was confirmed with a registration code of CRD42017076074.

Background One of the main elements that help students in research projects and composing dissertations is the student-supervisor relationship. A valid and reliable tool to measure this seems essential and it is the objective of the present study to validate and assess the psychometric properties of a questionnaire on supervisor-doctoral student interaction (QSDI) in Iran. Methods Before starting the study, a permission from the developer of the tool was secured. Then the tool was forward-backward translated. After preparing the Farsi version of the tool, content validity was confirmed through qualitative and quantitative methods. To examine construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted with participation of 218 and 410 MD, MSc, and PhD students of medical sciences, respectively. To check reliability of the tool, correlation coefficient was used. To examine internal consistency of the tool, Cronbach’s alpha was used. Data analyses were done in SPSS (v.25) and LISREL (v.8). Results The EFA and CFA results revealed eight factors and 39 items. The value of R-square for the model was equal to 0.99, which means 99% of changes in the dependent variable (supervisor-student interaction) is attributed to the independent variable (41 items). That is, 99% of the dependent variable changes is due to the independent variables. The main indices of the model based on factor analyses were supported (0.9 Conclusion In general, the results showed that the Farsi version of QSDI (eight factors and 39 items) had acceptable and applicable indices and it can be used as a valid tool in different fields for higher education students of medical sciences.

Nosocomial infections caused by Acinetobacter baumannii (A. baumannii) nosocomial infections caused by Acinetobacter baumannii (A. baumannii) are considered as a global serious problem in hospitalized patients because of emerging antibiotic resistance. Immunotherapy approaches are promising to prevent such infections. In our previous study, five antigenic epitopes of outer membrane protein A (OmpA), as the most dangerous virulence molecule in A. baumanii, were predicted in silico. In this study, the investigators evaluated some immunological aspects of the peptides. Five peptides were separately injected into C5BL/6 mice; then the cytokine production (interleukin-4 and interferon-gamma) of splenocytes and opsonophagocytic activity of immunized serum were assessed. To identify the protective function of the peptides, animal models of sepsis and pneumonia infections were actively and passively immunized with selected peptides and pooled sera of immunized mice, respectively. Then, survival rates of them were compared with the non-infected controls. Based on the results, activated spleen cells in P127 peptide-immunized mice exhibited an increase level of IFN-γ compared with the other experimental groups, but not about the IL-4 concentration. The results of opsonophagocytic assay revealed an appropriate killing activity of produced antibodies against A. baumannii in a dose-dependent manner. Further, the survival rates of the mice under passive immunization with the immunized sera or active immunization with P127 peptide were significantly more than those in the control group. Moreover, the survival rate of the P127 peptide immunized group was considerably higher than that among the other peptide-immunized group. In conclusion, findings indicated that peptides derived from outer membrane protein-A can be used as a promising tool for designing the epitope-based vaccines against infections caused by A. baumannii.

Occupational hazards are among the major health problems worldwide, and there is the possibility of occurrence of accidents in all workplaces. Hospitals are one of the most vulnerable places in this regard. Therefore, the present study aimed to investigate factors affecting occupational hazards among operating room personnel at hospitals affiliated to Kermanshah University of Medical Sciences in 2018. In this descriptive-analytic research, 435 operating room personnel at hospitals affiliated to Kermanshah University of Medical Sciences were chosen selected through quota sampling and studied in 2018. The data collection tool was a two-part questionnaire, the first part containing the demographic information, and the second part consisting of 29 questions relating to occupational hazards. For data analysis, descriptive (frequency, percentage, mean and standard deviation) and inferential statistics (ANOVA and independent t-test) and SPSS statistical software version 23.0 were employed. The significance level was set at p

Objective: Sleep quality and risk of sleep apnea in smokers and nonsmokers living in Kermanshah province-Iran were compared. Methods: Based on the statistics available at Kermanshah Health Center, ...

Background The notable growth of the senior citizens population has caused problems and concerns in areas like healthcare, social care, and participation in society. The present paper is aimed at validating a Farsi version of the "International classification of functioning, disability, and health" for assessing elderly care needs in Kermanshah, Iran. Methods The original version of the tool was translated into Farsi using forward-backward method. The study group consisted of 301 senior citizens who were selected through cluster sampling. Validity of the tool was examined using Waltz and Basel's content validity index, face validity, and confirmatory factor analysis. The reliability of the tool was examined using Cronbach's alpha and internal correlation. Data analyses were performed in SPSS-25 and Amoss-16. Results Following confirmatory factor analysis, the number of factors decreased from nine to eight. The R2 index in the above model was estimated equal to 0.99; this indicates that 99% of the dependent variable changes (total score of ICF) are explained by the independent variables (eight items). All the indices were above 0.9, which indicates significance of the model (χ2/DF=2.7, CFI, NFI, GFI, TLI=0.9, REMSEA=0.078, R2=0.99). In addition, using internal correlation, the reliability of the tool obtained was equal to 0.77 for the whole tool and 0.7-0.87 for the sub-scales. Conclusion The Farsi version of ICF had acceptable and applied specifications to assess the care needs of senior citizens and it can be used as a valid tool in different areas of nursing performance and elderly health.

In recent years, researchers were attracted to nanomaterials components for their potential role in cancer treatment. This study aimed to develop a novel and biocompatible cobalt hydroxide (Co(OH)2) nano-flakes that is functionalized by glutamic acid (Glu) and conjugated to thiosemicarbazide (TSC) for anticancer activities against human breast cancer MCF-7 cells. Physico-chemical properties of the Co(OH)2@Glu-TSC nanomaterial are characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), energy dispersive X–ray (EDX) analysis, and Fourier-transform infrared (FT-IR) spectroscopy. MTT assay, flow cytometry, and caspase-3 activity analysis used for evaluating anticancer properties of the Co(OH)2@Glu-TSC nanomaterial. The MTT assay result showed cellular uptake of Co(OH)2@Glu-TSC and cell viability loss in a concentration-dependent. Results of flow cytometry and caspase-3 activity analysis indicated the stimulation of apoptosis through an increase in Caspase-3 and nucleus fragmentation. In general, our findings indicate the anticancer activities of Co(OH)2@Glu-TSC nanomaterial and so it can be considered as a new treatment for breast cancer. However, further in vivo studies are required to evaluate the accumulation of Co(OH)2@Glu-TSC nanomaterial in healthy organs, such as the liver, kidneys, brain, and testes, and potential toxic effects.

Background The rate of attempting suicide is growing due to the increasing social and economic problems and a variety of stresses taken by individuals in their lives. Helping people, boosting hope, and improving resilience to life hardships might be helpful in this area. This paper is an attempt to determine the effects of group reminiscence on hope and resilience in care-seekers who have attempted suicide. Method The study was carried out as a quasi-experimental interventional study. The participants were 57 care-seekers with a history of attempting suicide who met the inclusion criteria. The sampling was done through convenience sampling and the participants were grouped into control (n = 29) and experimental (n = 28) groups randomly. The experimental group received integrated reminiscence sessions (eight sessions; 60–90 min). Hope and resilience of the subjects were measured using Schneider's Hope Scale and Connor and Davidson’s Resilience Scale. The scales were filled out by the subjects before, immediately after, and 4 weeks after the intervention. Results The mean scores of hope in the experimental and control groups were 34.60 and 38.04, respectively, before the intervention. These figures immediately after the intervention were 44.07 and 35.96 in the experimental and control groups, respectively. 4 weeks after the intervention, the mean scores of hope in the experimental and control groups were 44.39 and 35.79, respectively, which is a statistically significant difference (p p Conclusion Group reminiscence has a positive effect on boosting hope and resilience in care-seekers who have attempted suicide.

Objective: To evaluate the effects of curcumin (CUM) against Nicotine (NIC) induced damage to the hippocampal cortex of rats. Materials and Methods: In this study, 48 Wistar male rats were randomly assigned to eight groups: normal group, NIC group (0.5 mg/kg), CUM groups (10, 30, and 60 mg/kg), and NIC + CUM groups (10, 30, and 60 mg/kg). Treatments were administered intraperitoneally (i. p) daily for 28 days. Golgi and cresyl violet staining techniques were employed to investigate the number of neurons and dendritic spines. The techniques of Griess, ferric reducing/antioxidant power, and hippocampal malondialdehyde (MDA) were used. Results: NIC administration significantly increased the nitrite oxide (NO) and MDA levels and decreased the total antioxidant capacity (TAC) as well as the number of neuronal dendritic spines and neurons compared to the normal group (P

Considering the high prevalence of Methamphetamine dependence and its severe complications, the risk factors and various factors in the tendency to substance should be investigated. Therefore, the aim of the present study was to predict methamphetamine dependence based on psychological and brain-behavioral system features. In this correlational descriptive study, 100 of all eligible methamphetamine dependents admitted in Farabi Hospital, Kermanshah, Iran in 2016 and 100 healthy persons were selected as the control by convenience sampling method. Data were collected from the Self-report psychometric questionnaire (SCL-90) and Carver & White's Brain-Behavioral Questionnaire, and were analyzed by discriminant analysis. The coefficients of the audit function indicated that discordance, obsession, anxiety and sensitivity in relationships had the most roles in the diagnostic function, and the variables of impulsivity, paranoid, and novelty seeking had the lowest role in diagnostic function and its success. Also, the discriminant analysis method showed that the linear combination of the above variables can explain about 85.3% of the variance difference between two groups. According to the study findings, it is recommended that in prevention, treatment strategies, the role of psychological and brain-behavioral system features consider.

Purpose: In this study, the effects of different intensities of Static Magnetic Fields (SMFs) (10, 15 and 25 mT) and different concentrations of cisplatin drug were investigated on the viab...

The present study was aimed to develop an effective nanoliposomal vaccine delivery system with P435 HER2/neu-derived peptide conjugated to Maleimide-PEG2000-DSPE. The nanoliposome formulation composed of DSPC/DSPG/Chol/DOPE and monophosphoryl lipid A was used as an adjuvant. Liposomal formulations were prepared and their physical properties were characterized. Anti-tumoral efficacy of formulations was evaluated by immunization of tumor-bearing BALB/c mice and the generated immune response was studied by using ELISpot and flow cytometry analysis. The results of the study demonstrated Lip + DOPE + P535 formulation caused the lowest tumor size and the longest survival time in TUBO mice model and could make it a promising candidate in developing effective vaccines against HER2-positive breast cancers.

Background Undesirable effects Negative feelings among women with unintended pregnancies may have undesirable effects on pregnancy. However, little is known about the effect of positive feelings and protective factors on prenatal mental health of pregnant women. The aim of the present study was to determine the effect of positive psychology-based interventions (PPI) on the happiness of women with unintended pregnancies. Methods This randomized controlled trial that included 40 women with unintended pregnancies was conducted between March and July 2017. The subjects were randomly assigned to receive 10 weekly training sessions based on positive psychology (PPI) (N = 20) or routine prenatal care (N = 20). All subjects received usual prenatal care. The level of happiness and its five domains were measured in three time points: at baseline, immediately after completing the intervention, and 45 days after the end of the intervention. The happiness was assessed using the Oxford Happiness Inventory (OHI). Results In the intervention group, the mean total OHI score increased from 31.3 (at baseline) to 42.5 (after completing ten sessions of PPI), and the increase remained statistically significant at a 45-day follow-up (39.8); P = 0.001. However, the total OHI score did not change significantly during the follow-up (P = 0.339). Satisfaction with life, self-esteem, and subjective well-being improved significantly after the interventions, whereas the increases observed in the scores of positive mood and self-efficacy dimensions were not significant. Conclusion PPIs can improve happiness and its dimensions among women with unintended pregnancies. It is suggested that healthcare planners help women with unplanned pregnancies adapt by formulating strategies to hold training courses with a positive psychology approach and recognize and promote their positive aspects and strengths., Positive psychology; Unintended pregnancies; Prenatal mental health.

Background Depression and fatigue are common consequences of breast cancer that lead to dysfunction and reduced quality of life of patients. The aim of the present study was to determine the effect of exercise program on depression and fatigue in breast cancer women undergoing chemotherapy. Methods This randomized controlled trial study was performed on 60 breast cancer women undergoing chemotherapy in Kermanshah hospitals from 2017-2018. Participants were selected using convenience sampling and were randomly divided into intervention and control groups. Data collection tools included demographic information form and standard Beck depression inventory (BDI-II) and fatigue severity scale (FSS). The intervention group performed the 20-30-minute indoor exercise program 3 sessions a week for 6 weeks. Questionnaires were completed before, immediately, and one month after the intervention by both groups and data analysis was carried out using SPSS ver.22. Results There was no statistically significant difference between the two groups in terms of the mean fatigue intensity and depression scores before the intervention; however, the mean fatigue intensity scores were significantly decreased in the intervention group as compared to the control group immediately and one month after the intervention (P = 0.001). There was no statistically significant difference between the two groups in terms of mean depression score immediately and one month after the intervention (p > 0.05). Conclusion Considering that indoor exercises reduced fatigue in breast cancer women undergoing chemotherapy, patients are recommended to perform exercise interventions as a non-pharmacological, safe, easy, and non-invasive solution to improve their physiological capacities and functional abilities as well as Quality of life. On the other hand, since exercise program had no effect on depression among breast cancer women in the present study, longer studies with larger sample size are recommended., Depression, Fatigue, Breast cancer, Exercise, Randomized controlled trial.

Pseudomonas aeruginosa (P. aeruginosa) is an opportunistic pathogen in burns, cystic fibrosis, hospitalized and immunodeficiency patients. By in-silico algorithms an effective vaccine was designed from outer membrane proteins (OprF and OprI) and type 3 secretion systems (PopB) of P. aeruginosa to combat laboratory barriers and store time, reduce cost, and achieve higher performances. The aim of this study was the construction, expression, and evaluation of recombinant protein containing OprF, OprI, and PopB (FIB). We combined the in-silico immunoinformatics, homology modeling, molecular docking and molecular dynamics (MD) simulations. The linear and conformational B-cell epitopes and T-cell epitopes in the 172 subunit candidates were investigated and the best 16 of them was recognized to create a multi-epitope vaccine. Ultimately, we realized stable interactions between the epitopes of “NATAEGRAINRRVE” OprF in 305–318 and “KAANRQADVQESRAD” PopB in the position of 730–744 as ligands and HLADRB1*04:01 as a receptor. This proposed vaccine constructs a 794aa multi-epitope vaccine containing 66 B-cell epitopes and 106 T-cell epitopes. The levels of IgG (G1, G2a, and G2b) and IgA antibody titers and the level of IL-17, IFN-γ, and IL-4 cytokines were evaluated before and after challenge using the enzyme-linked immunosorbent assay (ELISA) method. Due to enhancing the active immune response, FIB antigen was formulated with Granulocyte-macrophage colony-stimulating factor (GM-CSF) as a potent adjuvant. The comparison of IgG1, IgG2a, IgG2b antibodies, cytokines IL-17, IL-4, and IFN-γ levels indicated a higher rate of Th1 and Th2 oriented responses against P. aeruginosa chimeric FIB antigen. The FIB antigen was a potent IgA inducer in the presence of adjuvant. Also, the immunogenic response against FIB and FIB-GMCSF revealed the useful property of GM-CSF in enhancing the humoral and cell-mediated immune response. Our findings highlighted that FIB plus GM-CSF immunization would be useful as an immunogenic substance for treatment against P. aeruginosa infections.

Background Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. Findings We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. Interpretation Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. Funding Bill & Melinda Gates Foundation.

Background Organ donation following brain death has become an important way of supplying organs for transplantation in many countries. This practice is less common in Iran for different reasons. Therefore, this study aims to explore the obstacles to organ donation following brain death in Iran. Methods This qualitative research was conducted following the conventional content analysis method. The study population consisted of individuals with a history of brain death among their blood relatives who refused to donate the organs. Snowball sampling was employed to select the participants. In-depth semi-structured interviews were conducted for data gathering. Theoretical saturation was achieved through 20 interviews. Data analysis was done following the steps proposed by Graneheim and Lundman. Lincoln and Guba’s criteria were used to ensure data rigor and transferability of the study. Results Data analyses revealed 185 codes, 23 categories, and seven themes including, poor knowledge about brain death and organ transplantation from a dead body, cultural beliefs, religious beliefs, deficiencies of requesting process, fear and concerns, inability to make a decision, and social learning. Conclusion There were several factors in families’ reluctance to donate organs of a brain-dead patient. Through improving knowledge and changing cultural beliefs in society, it is possible to take large steps towards promoting organ donation from brain-dead patients.

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce highresolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. This work was primarily supported by a grant from the Gates Foundation (OPP1132415). LGA has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado de Minas Gerais. OOA acknowledges the Department of Science and Innovation, National Research Foundation, and DSI/NRF Centre of Excellence for Epidemiological Modelling and Analysis, Stellenbosch, South Africa. SMAl acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. HTA acknowledges Aksum University. MAu and CH are partly supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. AAz acknowledges funding from the Gates Foundation (OPP1171700). ABad is supported by the Public Health Agency of Canada. TWB was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the EU; the Wellcome Trust; and from National Institute of Child Health and Human Development of National Institutes of Health (NIH; R01-HD084233), National Institute on Aging of NIH (P01AG041710), National Institute of Allergy and Infectious Diseases of NIH (R01-AI124389 and R01-AI112339), as well as Fogarty International Center of NIH (D43-TW009775). DABen was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care. GBB is supported by Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. FCar acknowledges UID/ MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/Ministério da Ciência, Tecnologia e Ensino Superior through national funds. VMC acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. JDN acknowledges support from the Alexander von Humboldt Foundation. DBD acknowledges support from the Gates Foundation. KD is supported by a Wellcome Trust grant (number 201900/Z/16/Z) as part of his International Intermediate Fellowship. AGo acknowledges Sistema Nacional de Investigadores de Panamá (SNI), Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). CH is partly supported by a grant co-funded by European Fund for Regional Development through the Operational Program for Competitiveness (project ID P_40_382). SMSI is funded by a Fellowship from National Heart Foundation of Australia and Deakin University. MJ and the Serbian part of this GBD contribution was co-funded through grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. JK is a recipient of the 2020 Benjamin V Cohen Peace Fellowship from Ball State University Center for Peace and Conflict Studies. YJK’s work was supported by the Research Management Centre, Xiamen University Malaysia, grants number XMUMRF/2018-C2/ ITCM/0001. KKr is supported by a DST PURSE grant and UGC Center of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. BL acknowledges support from the NIHR Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence, Oxford. PTNM acknowledges the Council for the Development of Social Science Research in Africa. ANA acknowledges Debre Markos University for its support in-terms of office and internet access while reviewing this paper. AMSam received a fellowship from the Egyptian Fulbright Mission programme. MMS-M acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). AShi acknowledges the support of Health Data Research UK. MRS acknowledges the Clinical Research Development Center of Imam Reza Hospital, Kermanshah university of Medical sciences for their wise advice. JBS is part of Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. RT-S was supported in part by grant PI17/00719 from Instituto de Salud Carlos III–FEDER. BU acknowledges Manipal Academy of Higher Education, Manipal. TWij acknowledges the Migraine Foundation Australia and the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Anuradhapuraya, Sri Lanka. CSW was supported by the South African Medical Research Council. SBZ received a scholarship from the Australian Government research training program in support of his academic career.

Background: Rhinoplasty is a cosmetic surgery for which the society and the individual incur heavy costs. The present study is an attempt to elaborate on the causes and challenges of males’ rhinoplasty in Iranian population.Methods: The study was carried out as a qualitative study using content analysis method. Totally, 20 participants (16 clients, one family member, and three care-givers) were selected purposefully and participated in semi-structured and in-depth interviews. With 20 interviews, data saturation was achieved. Data analysis process was conducted manually along with the interviews following Lundman and Graneheim method.Results: Data analysis revealed 614 primary codes and the continuous examination and removal or repetitious codes left 417 codes, nine sub-themes, and two themes namely the reasons for rhinoplasty (lack of confidence, hope for a better face, seeking attention, keeping up with the Joneses, and persuasion by others) and challenges (family challenge, social atmosphere, financial problems, and unwanted consequence).Conclusion: The lack of confidence and the hope of having a more beautiful face were the motivators. Family challenges, financial problem and the negative side effects of the surgery were challenges in the way of men for having rhinoplasty.

The nuclear factor kappa B (NF-kB) family of transcription factors plays an essential role as stressors in the cellular environment, and controls the expression of important regulatory genes such as immunity, inflammation, death, and cell proliferation. NF-kB protein is located in the cytoplasm, and can be activated by various cellular stimuli. There are two pathways for NF-kB activation, as the canonical and non-canonical pathways, which require complex molecular interactions with adapter proteins and phosphorylation and ubiquitinase enzymes. Accordingly, this increases NF-kB translocation in the nucleus and regulates gene expression. In this study, the concepts that emerge in different cellular systems allow the design of NF-kB function in humans. This would not only allow the development for rare diseases associated with NF-kB, but would also be used as a source of useful information to eliminate widespread consequences such as cancer or inflammatory/immune diseases.

Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). S Aljunid reports additional funding from the International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Health Policy and Management, Faculty of Public Health, Kuwait University for the approval and support to participate in this research project outside of the study. A Awasthi is supported by the Department of Science and Technology, Government of India, New Delhi, through the INSPIRE Faculty Program outside of the study. A Badawi reports additional funding from the Public Health Agency of Canada outside of the study. A Barac reports additional funding from the Project of Ministry of Education, Science and Technology of the Republic of Serbia (no III45005) outside of the study. T Bärnighausen reports additional funding by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research outside of the study. F Carvalho and E Fernandez report additional funding from the Portuguese national funds (UID/MULTI/04378/2019 and UID/QUI/50006/2019) outside of the study. V M Costa reports additional funding from Fundação da Ciência e Tecnologia (FCT) for her grant (SFRH/BPD/110001/2015), which was funded by national funds through FCT – Fundação para a Ciência e a Tecnologia, IP, under the Norma Transitória – DL57/2016/CP1334/CT0006 outside of the study. J De Neve reports additional funding from the Alexander von Humboldt Foundation outside of the study. K Deribe reports additional funding from the Wellcome Trust (grant number 201900) as part of his International Intermediate Fellowship outside of the study. D Endalew and M Moradi report additional funding from Wolkite University. M Ausloos, C Herteliu, and A Pana report additional funding from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI (project number PN-III-P4-ID-PCCF-2016-0084) outside of the study. C Herteliu reports additional funding from the European Fund for Regional Development through Operational Program for Competitiveness (Project ID P_40_382) and the European Fund for Regional Development, through InterReg Romania-Hungary (project code EMS ROHU 217) outside of the study. P Hoogar reports additional funding from the Centre for Holistic Development and Research (CHDR), Kalaghatagi and The Department of Studies in Anthropology, Karnatak University, D S Islam reports additional funding from the National Heart Foundation of Australia and the Institute for Physical Activity and Nutrition, Deakin University outside of the study. A Khatony reports additional funding from the Clinical Research Development Center of Imam Reza Hospital in Kermanshah outside of the study. J Khubchandani reports additional funding from Merck Research Laboratories outside of the study. K Krishan reports additional funding from the UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India outside of the study. M Kumar reports additional funding from the Fogarty Foundation/NIH through a K43 award (TW010716-01A1) outside of the study. B Lacey reports additional funding from the National Institute for Health Research Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence (Oxford, UK) outside of the study. A M Samy reports additional funding from the Egyptian Fulbright Mission Program (EFMP) outside of the study. S Seyedmousavi reports additional funding from the Intramural Program of National Institute of Health Clinical Center, Bethesda, MD, USA outside of the study. M Shey reports additional funding from the Wellcome Trust Kenji Shibuya reports additional funding from Japan's Ministry of Health, Labour and Welfare and Japan's Ministry of Education, Culture, Sport, Science and Technology outside of the study. M Sobhiyeh reports additional funding from the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences outside of the study. J Soriano reports additional funding from Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain outside of the study. N Taveira reports additional funding from the LIFE study (RIA2016MC-1615) of the European and Developing Countries Clinical Trials Partnership (EDCTP) program supported by the European Union outside of the study. B Unnikrishnan reports additional funding from the Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India outside of the study. T Wijeratne reports additional funding from the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Sri Lanka outside of the study. C S Wiysonge reports additional funding from the South African Medical Research Council and the National Research Foundation of South Africa outside of the study.

Background: Drug dependence or substance use disorder not only affects a person’s life but also brings a lot of challenges for families and communities and imposes heavy burdens on them. There are various therapies in the domain of addiction whose main purposes are to reduce or to cut down substance abuse. Objective: This study aimed to determine the effectiveness of group spiritual intervention on selfesteem and happiness among male clients undergoing methadone maintenance treatment. Methods: This study was an intervention study in which 60 clients affected with substance abuse and undergoing methadone maintenance treatment were recruited. The study samples were selected through convenience sampling method and then divided randomly into two groups of 30 individuals: intervention and control. The intervention group attended group spiritual interventions for 10 sessions. Self-esteem and happiness among the study participants were also measured through Coopersmith Self-Esteem Inventory and Oxford Happiness Questionnaire before and after the intervention. Results: The results showed a significant difference between both intervention and control groups in terms of self-esteem and happiness (P < 0.05); so that the participants in the intervention group demonstrated a significant improvement in their self-esteem and happiness. Conclusion: It was concluded that group spiritual intervention as a useful method could be effective in enhancing self-esteem and happiness among addicted individuals undergoing methadone maintenance treatment. The given treatment could be also used as a complementary therapy beside methadone maintenance treatment to reduce the likelihood of people returning to substance abuse.

At present, the universal health problem with Staphylococcus aureus is the emergence of multidrug-resistant strains due to the overuse of antibiotics. Drug extrusion through efflux pumps is one of the bacterial mechanisms to neutralize the bactericidal effect of antibiotics. The antibacterial activity of silver nanoparticle as well as Fe3O4 nanoparticle had been previously studied and widely described. Today, the development of green methods for nanomaterial synthesis is an important aspect of research in the field of nanotechnology. Here, we report the biosynthesis and characterization of Fe3O4@Ag nanocomposite by Spirulina platensis cyanobacterium and it impacts on the expression of efflux pump genes in ciprofloxacin-resistant S. aureus (CRSA). The physical properties of biosynthesized nanocomposite measured and confirmed by ultraviolet-visible spectroscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, energy-dispersive X-ray spectroscopy, and scanning and transmission electron microscopy. The minimum inhibitory concentration (MIC) of ciprofloxacin in CRSA strains was determined in the presence of Fe3O4@Ag nanoparticles by broth microdilution method. The effect of Fe3O4@Ag nanocomposite on the expression of norA and norB genes was evaluated by real-time PCR. The physical analysis confirmed well-dispersed, highly stable, and mostly spherical Fe3O4/Ag NPs with the average size of 30–68 nm. The results of antibacterial tests showed the synergistic effects of nanocomposite and antibiotics in MIC reduction. Additionally, in the presence of Fe3O4@Ag nanocomposite, the expression of norA and norB genes was decreased more than twofold compared to control. In conclusion, the Fe3O4/Ag nanocomposite can use as an effective inhibitor of antibiotic resistance in medicine.

The study was aimed at evaluating antitumor and immunomodulatory effects of liposomal vaccine composed of P5 human epidermal growth factor receptor 2 (HER2)/neu-derived peptide coupled to the surface of high-temperature nanoliposomes containing distearoylphosphocholine:distearoylphosphoglycerol:Chol:dioleoylphosphatidylethanolamine (DOPE) comprising monophosphoryl lipid A (MPL) adjuvant in HER2/neu overexpressing the breast cancer model. BALB/c mice bearing TUBO carcinoma were subcutaneously immunized with formulations containing 10 µg P5 peptide and 25 µg MPL three times with 2-week intervals. To determine immuno responses in immunized mice, the amount of released interferon-γ and IL-4 were measured by the enzyme-linked immunospot method and the flow cytometric analysis on the isolated splenocytes. The results demonstrated that tumor-bearing mice immunized with Lip/DOPE/MPL/P5 formulation had the most released interferon-γ and the highest cytotoxic T lymphocyte responses that led to the lowest tumor size and the longest survival time than those of other formulations. The results achieved by Lip/DOPE/MPL/P5 formulation could make it a suitable candidate to induce effective antigen-specific tumor immunity against breast cancer.

Objective: Our study aimed to clarify of factors affecting decisions to use a surrogate mother can create broad knowledge of this concept. Materials and methods: For This qualitative research, participants were selected through snowball sampling methods out of couples with a history of using surrogacy as an alternative treatment for having a child. As well, sampling continued until data saturation was reached. Finally, 23 persons participated in study (9 couples, 5 related persons). After selecting the participants and obtaining informed consent, in-depth and semi-structured interviews were conducted and most of them were recorded with participants’ consent. Then, all the interviews were analyzed using a conventional method. Results: Content analysis of the statements condenced to 311 codes, 13 subcategories and 5 categories including the absence of parental role, perceived norm, hope for parenting role, mental challenge, and decision to use surrogacy were extracted. Conclusion: The results indicated that numerous variables had an effect on decision-making process to use a surrogate mother, but the variable of hope for parenting role was an influential concept that not only interacted with other concepts but also caused optimism and motivation in families to decide in this respect.

Background Persons who use drug need family and society’s support in the process of treatment and rehabilitation. Therefore, it is imperative to determine the psychological, social, and motivational factors that can help them in the treatment process. The present study was an attempt to determine the relationship between psychological, social, and motivational factors and the demographics of persons who use drugs (PWUD). Methods An analytical cross-sectional study was carried out. TCU psychological functioning and motivation scales for the PWUD was first translated into Farsi and validated after securing permission from the copyright holder of the tool. Participants were 250 PWUDs under methadone therapy who were selected through convenient sampling. Before analyzing the collected data, validity and reliability of the tool were confirmed using confirmatory and exploratory factor analyses. Given the scale of demographical data, descriptive and analytic statistics were used to analyze the relationship between demographical variables and psychological, social, and motivational factors. Results The results of exploratory and confirmatory factor analyses showed that out of 83 statements in the original questionnaire, 55 statements categorized into 11 aspects were usable for Iranian population. The results showed that gender, income, and marital status affect psychological functioning of the PWUD (P p > 0.05). There was a significant relationship between age, number of children, and history of using drug and psychological functioning of the participants (P P Conclusion As the results showed, the demographical variables could affect physical, psychological, and social functioning in the participants.

Silver nanoparticles (AgNPs) are one of the new cancer treatment tools due to their unique properties that enhance potential therapeutic efficacy. In this study, we describe the extracellular biosynthesis and anticancer activity of AgNPs using the Anabaena flos-aquae biomass extract as reducing agent. The formation of dark-brown $$\hbox {AgNO}_{{3}}$$ /extract solution confirmed the reduction of silver ions into AgNPs. In addition, the ultraviolet–visible spectroscopy showed the surface plasmon peak at 425 nm as characteristic peak for AgNPs. Transmission electron microscopy and scanning electron microscopy showed highly stable and mostly spherical AgNPs with average size of 5–25 nm. Fourier transform infrared spectral analysis confirmed the presence of biomolecules in the extract involved in the reduction and stabilization of AgNPs. In vitro, study of anticancer and cytotoxic effect of AgNPs and extract against T47D cell lines by MTT assay and flow cytometry confirmed the anti-proliferation potential of AgNPs against breast cancer cells. In conclusion, our results revealed that Anabaena can be used as a good organism for biologically synthesis of AgNPs and confirmed the potent therapeutic value of these nanoparticles as anticancer drugs.

As one of the most recently (re)discovered types of non-coding RNAs (ncRNA), circular RNAs (circRNAs) differentiate from other ncRNAs by a specific biogenesis, high stability, and distinct functions. The biogenesis of circRNAs can be categorized into three mechanisms that permit the back-splicing reaction: exon-skipping, pairing of neighboring introns, and dimerization of RNA-binding proteins. Regarding their stability, circRNAs have no free ends, specific to linear RNA molecules, prompting a longer half-life and resistance to exonuclease-mediated activity by RNase R, bypassing the common RNA turnover process. Regarding their functions, circular transcripts can be categorized into four broad roles: miRNA sponging, protein binding, regulation of transcription, and coding for proteins and peptides. Female reproductive system (including mainly ovarian, corpus, and cervix uteri cancers) and breast cancers are the primary causes of death in women worldwide, accounting for over 1,212,772 deaths in 2018. We consider that a better understanding of the molecular pathophysiology through the study of coding and non-coding RNA regulators could improve the diagnosis and therapeutics of these cancers. Developments in the field of circRNA in regard to breast or gynecological cancers are recent, with most circRNA-related discoveries having been made in the last 2 years. Therefore, in this review we summarize the newly detected roles of circRNAs in female reproductive system (cervical cancer, ovarian cancer, and endometrial cancer) and breast cancers. We argue that circRNAs can become essential elements of the diagnostic and therapeutic tools for female reproductive system cancers in the future.

Methadone treatment is a conventional treatment with a harm-reduction approach used in addiction treatment. Psychological needs are important factors affecting the retention in treatment for these ...

Mohammad Moslem Imani,1 Amir Jalali,2,3 Ebraheim Ezzati,4 Zeinab Heirani,5 Mohammadreza Dinmohammadi6 1Department of Orthodontics, Faculty of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran; 2Department of Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; 4Anesthesiology Medical Department, School of Paramedical Kermanshah, University of Medical Sciences, Kermanshah, Iran; 5Department of Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran; 6Department of Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran Background: Orthodontics is a medical treatment and a rehabilitation service provided for individuals in need. Due to the high cost involved in performing this type of treatment along with the current attitude in communities toward it as a cosmetic service, it is essential to investigate the decision-making process to undergo orthodontic interventions among Iranian individuals and families.Methods: To conduct this qualitative study using grounded theory, 18 participants were selected through purposive sampling method and received semi-structured interviews each lasting 50–70 minutes. Eventually, the data were saturated after the fulfillment of 19 interviews. During the interviews, simultaneous analysis was also performed according to the method proposed by Strauss and Corbin (1998) and then the data were analyzed within three stages of open, axial, and selective coding.Results: Analysis of the clients’ statements produced 207 codes, 22 sub-categories, and 9 main categories, including distorted mental self-image, hope to look more attractive, inappropriate interactions with family and those around, family’s views toward the problem, social conditions, financial constraints, challenges in the family, as well as decision making to undergo orthodontic treatment, and finally, the main factor of hope for a better future were highlighted.Conclusion: The results showed that the main facilitating factor was “hope for a better future” for which families could accept numerous difficulties, such as high cost and repeated follow-ups due to the importance of beauty and meeting their children’s sense of satisfaction. Keywords: orthodontics, grounded theory, decision making, esthetics

The surface of nanoparticles (NPs) get coated by a wide range of biomolecules, upon exposure to biological fluids. It is now being increasingly accepted that NPs with particular physiochemical properties have a capacity to induce conformational changes to proteins and therefore influence their biological fates, we hypothesized that the gold NP’s metal surface may also be involved in the observed Fg unfolding and inflammatory response. To mechanistically test this hypothesis, we probed the interaction of Fg with gold surfaces using molecular dynamic simulation (MD) and revealed that the gold surface has a capacity to induce Fg conformational changes in favor of inflammation response. As the integrity of coatings at the surface of ultra-small gold NPs are not thorough, we also hypothesized that the ultra-small gold NPs have a capacity to induce unfolding of Fg regardless of the composition and surface charge of their coatings. Using different surface coatings at the surface of ultra-small gold NPs, we validated this hypothesis. Our findings suggest that gold NPs may cause unforeseen inflammatory effects, as their surface coatings may be degraded by physiological activity.

Background: It is obvious that hemodialysis is a stressful process, leading to numerous social and psychological problems, and may cause fatigue and helplessness. Objective: This study aimed to explain the experiences of hemodialysis clients regarding the effect of psychological problems on fatigue. Methods: This article was extracted from a qualitative study conducted on clients undergoing hemodialysis in Khorramabad. To this end, a total of 15 participants were purposefully selected using the snowball sampling method and the required data was collected using individual, face to face, detailed and semi-structured interviews. There were 12 client interviewees and one doctor, one nurse and one hemodialysis client's spouse. Content analysis was used to analyze the data. Results: Continuous analysis of data and documents obtained from the interviews on the hemodialysis clients' experiences and comments regarding the main causes of fatigue revealed two main categories: 1) Psychological effects with subcategories of psychological stress and exhaustion; 2) Needs and constraints with subcategories of individual and social needs and constraints. Conclusion: According to the clients' speech and expression analysis, psychological impacts and disease-induced needs and constraints were the most important cause of fatigue and its continuation among these clients. Keywords: Fatigue, Hemodialysis, Patients, Pressure, Qualitative research

BACKGROUND: Decision making about the type of dialysis in renal failure is a matter of great importance involving the patients, his/her family, and the health care team. Identifying the factors influencing decision making for undergoing peritoneal dialysis (PD) helps the development of this therapeutic method in patients. AIM: The present study aims at explaining the factors influencing decision making about undergoing PD in End Stage Renal Failure patients METHOD: The present study is a qualitative research, which used content analysis method. A semi-structured and in-depth interview was conducted with the 19 participants that selected by purposefully sampling. All interviews were recorded subsequent to receiving consent of the participants and were analyzed using content analysis method. RESULTS: The first codification process resulted in 345 codes, which finally decreased to 278 codes by continuous reading and removal of duplicates. Overall, two main categories and eight categories namely facilitating factors (viz. family atmosphere, hemodialysis problems, PD advantages, and social environment) and inhibitory factors (viz. inefficient family, PD requirements, attitudes towards hemodialysis, and the country treatment system) were selected from the total 19 sub-categories and 278 codes. CONCLUSIONS: Results indicated that various personal, family-related, psychological, social, and economic factors could affect the decision on the type of dialysis in patients. Therefore, basic infrastructures such as social support, education, and even the specialist and positive perspective of the Ministry of Health are required to choose this therapeutic method.